Provider Demographics
NPI:1932711777
Name:BLANDING, ALICIA (RN)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:BLANDING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:PROF
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:BLANDING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:865 SAINT PAUL CHURCH CIR
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020-1647
Mailing Address - Country:US
Mailing Address - Phone:893-420-3013
Mailing Address - Fax:
Practice Address - Street 1:865 SAINT PAUL CHURCH CIR
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020-1647
Practice Address - Country:US
Practice Address - Phone:893-420-3013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19206163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health